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Organization
FAMILY HOME CARE AGENCY
Active
Organization
FAMILY HOME CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO GILES (ADMINISTRATOR)
(228) 243-6227
Entity
Organization
Contact information
Practice address
216 N CHRISMAN AVE, CLEVELAND, MS 38732
(662) 843-8797
Mailing address
303 COTTON ROW STE 110, CLEVELAND, MS 38732-2647
(662) 721-3422
(888) 331-6886
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/25/2013
Last updated
08/16/2018
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